Following an outbreak of yellow fever in Angola this past December and the subsequent confirmation of dozens of cases in the Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières (MSF) teams are providing support in both countries to help contain the spread of the disease.
On May 19, the World Health Organization found that the outbreak, though serious and of grave concern, does not currently constitute a public health emergency of international concern. To prevent further spread of the disease MSF teams are working with Ministries of Health to provide treatment, vaccines and to carry out yellow fever vector control activities.
Prevention in DRC
Since the end of February, 48 cases have been confirmed in the DRC. The majority are among people arriving from Angola, but three locally transmitted cases were also identified in Kinshasa and in the provinces of Kongo Central and Kwango, located on the Angolan border.
On May 26, MSF teams launched a vaccination campaign in Matadi, the capital of Kongo Central, intended for its 350,000 residents, as part of the Congolese Ministry of Health (MoH) program aimed at a target population of two million people. This single program covers two health districts in Kinshasa and nine health districts in Kongo Central. Also in cooperation with the Ministry of Health, MSF has launched vector control measures in Kinshasa and Kongo Central. These activities are intended to combat the Aedes aegypti mosquito, the carriers of yellow fever. Homes are being sprayed or fumigated to kill adult mosquitoes and destroy breeding sites where the mosquito lays its eggs, such as stagnant water. These activities are being carried out in locations where cases have been confirmed and in vulnerable locations such as hospitals, schools and markets.
MSF is also treating patients, providing medical supplies to identified health centres and training staff in yellow fever treatment.
“To eliminate any risk of the disease spreading, it is vital to be vigilant and responsive,” says MSF emergency coordinator Elisabetta Maria Faga. “There is no specific treatment for yellow fever. Prevention through targeted vaccination and vector control measures therefore remains the best weapon against the disease.”
Treating people in Angola
Since mid-February, MSF has been working in collaboration with Angola’s MoH, supporting yellow fever case management. MSF teams are directly treating yellow fever patients in the Kapalanga hospital in the capital of Luanda, as well as in Huambo, Huila and Benguela provinces. To date, MSF has treated close to 300 patients.
Teams have been deployed in Angola to provide diagnostics and treatment, as well as training national medical staff in case management. MSF is also supporting the implementation of the national protocol for responding to the disease and vaccination preparedness. Angola has so far reported 2,420 suspected cases (including 298 deaths), with 736 confirmed cases. Of the confirmed cases, 459 were in Luanda alone, with the rest in 13 other provinces. Angola’s MoH is conducting a mass vaccination campaign in the provinces, having already concluded a campaign in Luanda.
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Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients. The Aedes aegypti mosquito is the principal vector of yellow fever, which also transmits dengue, chikungunya and Zika. There is no treatment for yellow fever and vaccination is the most effective method of prevention. Symptoms include fever, headache and muscle pain, with some patients experiencing a more severe phase of high fever and internal bleeding. Up to 50 per cent of severely affected patients die within 14 days, according to the World Health Organization.